Adhesive prosthetics — gently replacing missing teeth

In the case of adhesive prosthetics, we replace missing teeth or tooth substance with specially bonded fixed ceramic restorations. This particularly gentle method is suitable for the aesthetic replacement of missing front and back teeth. Additionally, adhesive replacement of missing tooth substance with ceramic can be used to minimally invasive restore the original shape of the tooth. 

One great area of adhesive dentistry are adhesive bridges, also known as Maryland bridges (they were developed at the University of Maryland, USA), the bridge pontic, or missing tooth, is attached with one or two adhesive wings to the back of the adjacent teeth. In contrast to conventional bridges, this method protects healthy tooth substance, since very little dental enamel is removed on the oral side of the abutment teeth. In addition, the gums are not burdened and the aesthetic result is impressive. It is especially suitable for adolescent patients for whom implantation due to future jaw growth is not yet possible.


Fields of application for adhesive bridges

Adhesive bridges or Maryland bridges are a way to replace congential or otherwise missing back teeth easily, quickly and beautifully. We cement the bridges invisibly to one or two healthy neighbouring teeth. These must be largely free of caries and fillings. We can also bond the bridge to small composite fillings when fully enveloped by the bridge's wings. Adhesive bridge treatments are best when replacing only one missing back tooth. In the lower jaw we can replace up to four incisors. Large back teeth (molars) cannot be replaced with adhesive bridges because the chewing forces in this area are too great and crack the bond between the bridge and the tooth enamel.

We have the choice between double winged or single winged adhesive bridges as well as metal-ceramic or all-ceramic adhesive bridges. We will decide together with you which is best. All-ceramic bridges are, however, superior to metal-ceramic bridges in terms of aesthetics and biocompatibility. We nearly always recommend a single winged all-ceramic adhesive bridge, as it has been proven in various scientific studies to be an extremely reliable treatment option. If you want to check out how we solved a few case with Maryland bridges please visit our video library.

Adhesive bridge: treatment process

Before the treatment we thoroughly examine your teeth and take an impression, with which we can create planning models. In the preparation session we prepare the abutment tooth (between five and 10% of the clinical crown is removed), so that the adhesive wing finds support and clear cut margins are established. Then we take the final impression of your teeth, so that our dental laboratory can make the adhesive bridge.

After we have checked the fit and tooth color and you are satisfied with the result, we prepare the surfaces of the adhesive bridge and attach it using an acid-etching technique and a special adhesive cement (Panavia).

Advantages of adhesive bridges

  • Low level of invasiveness
  • No irritation of the pulp (the centre of the natural tooth)
  • No local anaesthesia needed
  • Healthy for gums
  • Maintenance of conventional preventive alternatives

Advantages for patients

  • Suitable for adolescents who are still growing
  • Lower risk of decay
  • Neighboring teeth are not blocked
  • Simple preparation

Adhesive bridges (Maryland bridges) instead of an implant or a conventional bridge

You do not always have to get implants or invasive bridges. This video, complete with pictures taken before and after the treatment, shows you when the use of adhesive bridges might make sense.


Another field of application of adhesive dentistry - tooth grinding

Tooth grinding or professionally called "bruxism" is an unhealthy habit as it can reduce otherwise healthly tooth substance rapidly. The causes for this are diverse and not yet fully explored. Most people grind their teeth at night, but some people do it unconsciously during the day. Teeth grinding is very common in children and infants. The most common cause is believed to be negative stress.


What happens when you grind your teeth?

Affected people usually unconsciously rub their teeth against each other, causing long-term damage to the dental substance. They often do it in their sleep, when the consciousness is completely switched off or with strong mental and emotional tension.
Teeth grinding is classified as a parafunction, since the triggered activity of the masticatory apparatus fulfills no real purpose. Nevertheless, the teeth are pressed together with great pressure, as the masticatory muscles work with even stronger biting forces than with normal chewing.

When the upper and lower jaws are maladjusted (a so called cranio-mandubular dysfunction, CMD) it can affect the harmony of the entire musculoskeletal system and lead to health problems like headache and tinnitus. Usually a CMD is usually noticeable by pain in the temporomandibular joint - and by clearly audible teeth grinding. But often tooth grinding does not always - especially in children - equal a CMD.

Tooth grinding is a relatively common phenomenon. For many adults, negative stress or unresolved mental problems are considered to trigger grinding. But also orthopedic problems of the temporomandibular joints or misaligned teeth or badly fitting dentures are viable causes. Likewise, alcohol or certain drugs are suspected.

Sometimes nocturnal teeth grinding is also a bad habit. The teeth grinding in children's sleep is often associated with improperly positioned deciduous teeth and disappears with the regrowth of permanent teeth.

 

Teeth grinding - consequences


Even when on slightly pressed together, the teeth are over-stressed and tooth substance is lost. The temporomandibular joints may also start to be painfull as a result of teeth grinding. In the worst casde when the joint discs slip, those affected can not even open their mouths properly anymore or close them only in pain. In addition, strong muscular tension in the neck and head area can develop. 

 

What can you do to stop grinding or at least reduce the impact?


The best option is to reduce stress. However, that is sometimes easier said than done. The easiest thing to do is to have a nightguard produced. Additionally, a massage therapy, a heat treatment and even autogenic training, yoga and thai chi can help to reduce nocturnal teeth grinding and the symptoms of bruxism. If tooth grinding has been reducing the tooth substance significantly you can re-establish the anatomy of the teeth with composite fillings (this is a more temporary option) or full ceramic partial crowns (so called table tops).

 

More questions?

Find answers to the most frequently asked ones below, or contact us for a personal consultation.

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